Background
The 'open' (external) and 'closed' (endonasal) rhinoplasty approaches remain a subject for debate. Semiopen approach was proposed by Inchingolo and colleagues in 2012 with the advantages of the open technique without division of the columella.
Patients and methods
A randomized prospective single-blinded study was conducted. Thirty patients were divided into two groups. In group A, 15 patients underwent rhinoplasty with the endonasal approach, whereas in group B, 15 patients were subjected to rhinoplasty with the semiopen approach. Parameters used for evaluation were recorded intraoperatively, at 1 week, and 3 months postoperatively.
Results
In group B, the operative time was longer and tip accessibility was better compared with group A, with a high statistical significance. Postoperative edema was more in group B than in group A, with a significant difference in the immediate postoperative period.
Conclusion
The semiopen approach shows better tip accessibility compared with the ordinary closed approach, with fewer incisions compared with the tip delivery technique and with no need for columellar division as in open approach. However, it has a longer operative time with more postoperative edema compared with the closed approach. Therefore, the best use of this approach is for cases in which tip modification is needed, especially if concomitant nasal dorsum modification is also needed.